Ethnic inequalities in cancer incidence and mortality: census-linked cohort studies with 87 million years of person-time follow-up

BACKGROUND: Cancer makes up a large and increasing proportion of excess mortality for indigenous, marginalised and socioeconomically deprived populations, and much of this inequality is preventable. This study aimed to determine which cancers give rise to changing ethnic inequalities over time. METHODS: New Zealand census data from 1981, 1986, 1991, 1996, 2001, and 2006, were all probabilistically linked to three to five subsequent years of mortality (68 million person-years) and cancer registrations (87 million person years) and weighted for linkage bias. Age-standardised rate differences (SRDs) for Māori (indigenous) and Pacific peoples, each compared to European/Other, were decomposed by cancer type. RESULTS: The absolute size and percentage of the cancer contribution to excess mortality increased from 1981-86 to 2006-11 in Māori males (SRD 72.5 to 102.0 per 100,000) and females (SRD 72.2 to 109.4), and Pacific females (SRD -9.8 to 42.2) each compared to European/Other. Specifically, excess mortality (SRDs) increased for breast cancer in Māori females (linear trend p < 0.01) and prostate (p < 0.01) and colorectal cancers (p < 0.01) in Māori males. The incidence gap (SRDs) increased for breast (Māori and Pacific females p < 0.01), endometrial (Pacific females p < 0.01) and liver cancers (Māori males p = 0.04), and for cervical cancer it decreased (Māori females p = 0.03). The colorectal cancer incidence gap which formerly favoured Māori, decreased for Māori males and females (p < 0.01). The greatest contributors to absolute inequalities (SRDs) in mortality in 2006-11 were lung cancer (Māori males 50 %, Māori females 44 %, Pacific males 81 %), breast cancer (Māori females 18 %, Pacific females 23 %) and stomach cancers (Māori males 9 %, Pacific males 16 %, Pacific females 20 %). The top contributors to the ethnic gap in cancer incidence were lung, breast, stomach, endometrial and liver cancer. CONCLUSIONS: A transition is occurring in what diseases contribute to inequalities. The increasing excess incidence and mortality rates in several obesity- and health care access-related cancers provide a sentinel warning of the emerging drivers of ethnic inequalities. Action to further address inequalities in cancer burden needs to be multi-pronged with attention to enhanced control of tobacco, obesity, and carcinogenic infectious agents, and focus on addressing access to effective screening and quality health care

3D quantitative analysis of early decomposition changes of the human face

Decomposition of the human body and human face is influenced, among other things, by environmental conditions.The early decomposition changes that modify the appearance of the face may hamper the recognition and identification of the deceased. Quantitative assessment of those changes may provide important information for forensic identification. This report presents a pilot 3D quantitative approach of tracking early decomposition changes of a single cadaver in controlled environmental conditions by summarizing the change with weekly morphological descriptions. The root mean square (RMS) value was used to evaluate the changes of the face after death. The results showed a high correlation (r = 0.863) between the measured RMS and the time since death. RMS values of each scan are presented, as well as the average weekly RMS values. The quantification of decomposition changes could improve the accuracy of antemortem facial approximation and potentially could allow the direct comparisons of antemortem and postmortem 3D scans

Personal Identification of Deceased Persons : An Overview of the Current Methods Based on Physical Appearance

The use of the physical appearance of the deceased has become more important because the available antemortem information for comparisons may consist only of a physical description and photographs. Twenty-one articles dealing with the identification based on the physiognomic features of the human body were selected for review and were divided into four sections: (i) visual recognition, (ii) specific facial/body areas, (iii) biometrics, and (iv) dental superimposition. While opinions about the reliability of the visual recognition differ, the search showed that it has been used in mass disasters, even without testing its objectivity and reliability. Specific facial areas being explored for the identification of dead; however, their practical use is questioned, similarly to soft biometrics. The emerging dental superimposition seems to be the only standardized and successfully applied method for identification so far. More research is needed into a potential use of the individualizing features, considering that postmortem changes and technical difficulties may affect the identification

Postmortem imaging of perimortem skeletal trauma

Various imaging modalities, including conventional radiography, computed tomography, magnetic resonance, and surface scanning have been applied in the examination of skeletal injuries in the forensic context. Although still not a substitute for a full medico-legal autopsy or the examination of skeletal remains, imaging is now increasingly used as a complementary tool in the postmortem analysis of perimortem skeletal trauma. Facilitated by the progress in general computational capacity, multimodal imaging has been proposed for comprehensive forensic documentation. A major advantage of these imaging approaches is that stored digital or physical 3D models of skeletal injuries can be reviewed at any time by various experts as well as be presented in court as evidence to clarify potentially complex medical and forensic aspects of the case. Due to constant technical progress in imaging techniques and software, continuous education, training, and sharing of expertise among engineers, computer scientists, and forensic experts, including forensic pathologists, anthropologists, and radiologists needs to be warranted to maintain high-quality expertise in the detection and interpretation of traumatic injuries on postmortem imaging. The technical developments and ever-improving user-friendliness of 3D imaging and modeling techniques present an atttactive alternative to traditional forensic approaches, but as long as the techniques have not been sufficiently tested and validated for forensic trauma analysis, and best practice manuals for forensic practice are lacking for both the technical procedures and method selection, the use of imaging techniques needs to be reevaluated on a case-by-case basis. In addition, ethical, legal, and financial aspects of the use of imaging and 3D modeling for forensic purposes need to be well understood by all parties in legal proceedings